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22.6 million children in developing countries do not receive life-saving vaccines that parents in wealthy nations take for granted. GAVI exists to redress this inequity

© UNICEF NYHQ2010-0655 Olivier Asselin

22.6 million children unimmunised

Every child, no matter where he or she is born, has the right to the opportunity of a healthy life and vaccines are one of the best ways to assure it.

  • They save lives.
  • They prevent disease so children can grow up to lead productive lives.
  • They are cost-effective and much cheaper than hospitalising a sick child.

Yet each year 22 million children - many of them in the poorest and most remote communities - do not have access to the most basic vaccines. One in five of all children who die before the age of five lose their lives to vaccine-preventable diseases. The overwhelming majority of these deaths occur in developing countries.

In January 2000, with global immunisation rates stagnating, the Global Alliance for Vaccines and Immunisation (GAVI) was launched to fund vaccines for children in more than 70 of the world's poorest countries. Its mission: to save children’s lives and protect people’s health by increasing access to immunisation in the world’s poorest countries.

Single-minded focus

By pulling the specialist skills of all the main players in immunisation -  WHO, UNICEF, the World Bank, the Bill & Melinda Gates Foundation, donor governments, developing countries, international development and finance organisations and the pharmaceutical industry - into one, decision-making body, GAVI has brought a single-minded focus to the urgent task of closing the gap between children for whom immunisation is a given and millions of children worldwide with no access to basic vaccines.

Five-year agenda

At GAVI's first ever pledging conference, held in London in June 2011, the Alliance embraced an ambitious five year agenda: assist developing countries to immunise an additional quarter of a billion children by 2015 and potentially save four million more lives. These goals were enshrined in a five-year strategy 2011-201, which includes strategic goals, a series of programmatic targets and a range of indicators to monitor progress towards fulfilling GAVI's mission. Click here to learn more about these strategic goals. 

Midway through GAVI's five-year strategy period, the Alliance is reaching a record number of children with life-saving vaccines. More countries than ever are introducing new vaccines, resulting in more deaths averted and increased health and wellbeing for millions of people. Click here to track our progress.

Global number of under-five children unimmunised with three doses of diphtheria, tetanus and pertussis vaccine (DTP3)
Revised figures for 2011 ( July 2012)
Sources/credits: WHO/UNICEF coverage estimates 2012 revision. July 2013.

Global number of under-five children unimmunised with 3 doses of  DTP

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The power of GAVI is its combination of public and private forces working together to achieve more than anyone could alone

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Public Private Partnership

GAVI's partners include leading multilateral organisations such as WHO, UNICEF and the World Bank, civil society organisations, public health institutes, donor and implementing country governments, major private philanthropists such as the Bill & Melinda Gates Foundation and "la Caixa", vaccine industry representatives, the financial community.

Focused agenda

Rather than duplicating the services of the many players in the field of health and vaccines, the GAVI Alliance channels its partners' specific skillsets into a single, cohesive agenda. Members contribute to the Alliance through participation in strategy and policy-setting, advocacy, fundraising, vaccine development and procurement, country support and immunisation delivery.

GAVI relies on the tried and tested skills of individual members to fulfill its mission. For example:

Best and the brightest

The Alliance also serves as a forum for collaboration, with partners' different skills and experience delivering new and better ways of improving routine immunisation.

Through active participation in GAVI task teams & working groups, the best and the brightest in immunisation bring new answers to key questions such as how to substantially increase the amount of funding available for vaccine support and how to introduce new vaccines at prices developing countries can afford.

First among equals

At all times, developing countries are first among equals in the GAVI Alliance. Health ministries in developing countries:

  • identify their own priorities and choose what GAVI support to apply for;
  • integrate GAVI support into their national health and immunisation plans;
  • contribute towards the cost of the vaccines they receive through co-financing.

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GAVI's innovative business model not only finances the introduction of new vaccines in developing countries but is also reshaping the vaccine market and ensuring immunisation programmes are sustainable

061800GEffective funding mechanism

GAVI seeks to make the right vaccines available in the right amount at the right price to the world's poorest countries.

Drawing on the skills of the key players in global immunisation, the Alliance's business model has provided solutions to six challenges that have slowed the introduction of life-saving vaccines to the world's poorest children:

1. Getting immunisation on the agenda

GAVI demonstrates that investing in immunisation programmes is cost-effective and supplies the evidence that encourages governments in donor and developing countries to support the introduction of new vaccines.

2. Securing predictable financing

Immunisation programmes need donor commitment that gives developing countries the confidence to adopt new vaccines and vaccine manufacturers the incentive to invest in the production of vaccines adapted to the needs of developing countries. GAVI's emphasis on innovative financing mechanisms and multi-year funding commitments from donors have secured long-term, predictable financing.

3. Putting countries in charge

International aid programmes were previously often project-based with external development agencies and donors defining the agenda.

GAVI's business model is built on the premise that developing countries should set their own priorities and ensure external support fits into the broader fabric of national health plans. GAVI uses existing partnerships and networks to implement the programmes.

4. Strengthening health delivery systems

Funding vaccines does not guarantee that they will reach the children who need them. GAVI allocates support to cash-based programmes designed to help countries strengthen their immunisation and health services. For example: health worker training, monitoring, logistics.

5. Making vaccines affordable

Ensuring a lasting impact on the vaccine market to the benefit of the low- and lower middle-income countries underlies the GAVI business model. GAVI influences vaccine prices using several strategies:

  • aggregating demand and procurement;
  • encouraging competition;
  • increasing transparency on vaccine demand, supply dynamics and pricing;
  • encouraging a low pricing tier that allows GAVI-eligible countries to access the same product at a fraction of the price charged in high-income countries;
  • ensuring countries that graduate from GAVI support continue to have access to low vaccine prices .

6. Country co-financing

To enhance country ownership of vaccine financing and set a path to financial sustainability, GAVI requires countries to contribute towards the cost of the vaccines they receive. Co-financing levels are determined by each country's ability to pay.

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GAVI supports new and underused vaccines and immunisation and health system strengthening

Programme portfolio

GAVI currently offers the following portfolio of programme support:

Applying for support

Country proposals for GAVI support are reviewed by an Independent Review Committee (IRC) composed of Alliance members which assesses their technical quality. The GAVI Alliance Board makes funding decisions based on IRC recommendations. GAVI support extends for the duration of national immunisation plans with countries submitting annual reports to the GAVI Secretariat.

GAVI's eligibility policy ensures the funding support focuses on the world's poorest countries.

6 million

Approximately six million future deaths averted from hepatitis B, Haemophilus influenzae type B, measles, pertussis, pneumococcal disease, polio, rotavirus diarrhoea and yellow fever since GAVI's launch in 2000.

WHO Department of Immunisation, Vaccines and Biologicals’ estimates and projections, as of October 2013

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